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Shoulder Bursitis Pain: Diagnosis, Treatment, and Acupuncture's Surprising Benefits

Writer's picture: Dr. Scott MartinDr. Scott Martin

Updated: Nov 18, 2024

Shoulder bursitis is a common cause of shoulder pain and stiffness, affecting daily activities and quality of life. Although there are many treatment options, acupuncture has gained popularity for its effectiveness in reducing pain and inflammation associated with this condition. In this article, we’ll break down the causes, diagnosis, and treatment options for shoulder bursitis, highlighting scientific evidence supporting acupuncture as a powerful treatment method - there is even a video demonstration on a patient.


Shoulder bursa
The bursa sits in the middle of the joint preventing surfaces rubbing together.

Key Takeaways

  • What is Shoulder Bursitis Pain? Inflammation of the shoulder’s bursa, causing pain and stiffness.

  • Diagnosis: Physical exams, imaging, and medical history review.

  • Development: Typically caused by repetitive shoulder movement, trauma, or poor posture.

  • Treatment Options:

    • Conservative: Rest, ice, physical therapy.

    • Medications: NSAIDs, corticosteroid injections.

    • Acupuncture: Proven to reduce pain, improve circulation, and reduce inflammation.

  • Scientific Support: Research confirms acupuncture’s effectiveness in reducing shoulder pain and improving mobility.

  • Prevention Tips: Maintain good posture, strengthen muscles, and avoid repetitive shoulder movements.

For anyone dealing with persistent shoulder pain, exploring acupuncture as part of a holistic treatment plan may offer lasting relief.



shoulder bursitis location
Shoulder bursitis pain tends more to be felt on the outside and back of the shoulder joint.

What is Shoulder Bursitis Pain?

Shoulder bursitis occurs when one or more of the bursae in the shoulder become inflamed. Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles around a joint. In the shoulder, these bursae reduce friction between the shoulder blade, rotator cuff, and the upper arm bone.


Causes and Risk Factors

Shoulder bursitis typically results from repetitive motions, injury, or prolonged pressure. Common causes and risk factors include:

  • Repetitive Activities: Sports, lifting, and other repeated movements that stress the shoulder.

  • Injury or Trauma: A direct hit or fall onto the shoulder.

  • Poor Posture: Incorrect posture strains shoulder muscles, increasing friction on the bursa.

  • Underlying Conditions: Rheumatoid arthritis, diabetes, and gout may increase the risk.


Differentiating Shoulder Bursitis, Rotator Cuff Tear, and Supraspinatus Tendonitis

Shoulder pain can stem from various issues, making it challenging to determine the exact cause. Three common sources of shoulder pain include shoulder bursitis, rotator cuff tears, and supraspinatus tendonitis. While they may present with similar symptoms, each condition affects different parts of the shoulder structure and may require different treatments. Here’s how to tell them apart.


1. Shoulder Bursitis

Shoulder bursitis is inflammation of the bursa—a small, fluid-filled sac that cushions the tendons and muscles around the shoulder joint. When the bursa becomes irritated, it swells, causing pain and discomfort.

  • Symptoms: Dull, aching pain that’s often felt on the outside of the shoulder. Pain may worsen with movement, particularly when raising the arm overhead or lying on the affected shoulder. Swelling and tenderness around the shoulder are also common.

  • Diagnosis: Physical exams focus on locating the pain and evaluating shoulder movement limitations. Imaging tests like ultrasound or MRI may show inflammation or fluid around the bursa.


2. Rotator Cuff Tear

The rotator cuff is a group of four muscles and tendons that stabilize the shoulder. A rotator cuff tear happens when one of these tendons is damaged, often from overuse, trauma, or age-related degeneration.


rotator cuff tear
A rotator cuff tear means that supraspinatus tendon is damaged and torn. Sypmtoms of strong pain and weakness are standard.

  • Symptoms: Sharp, intense pain, especially when lifting or rotating the arm. Weakness in the shoulder may make it difficult to lift objects or perform simple tasks. Patients may feel a popping sensation during movement and often have trouble sleeping on the affected shoulder.

  • Diagnosis: A physical examination will typically reveal weakness in the shoulder, especially in specific arm movements. Imaging tests, particularly MRI, are essential to confirm the tear’s location and severity.


3. Supraspinatus Tendonitis

Supraspinatus tendonitis is an inflammation of the supraspinatus tendon, one of the main tendons in the rotator cuff. This tendon passes through a narrow space and is prone to inflammation due to repetitive motion or overuse.


Supraspinatus tendonitis
An inflamed supraspinatus tendon is the most common shoulder injury

  • Symptoms: Pain in the upper shoulder area, particularly when lifting the arm sideways or overhead. The pain is often felt at the top and side of the shoulder and may worsen at night.

  • Diagnosis: A doctor may use the “empty can” test, where the patient holds their arm out as if pouring out a can. Pain during this motion suggests supraspinatus tendonitis. Ultrasound or MRI can also help visualize inflammation in the tendon.


chart of shoulder bursitis differentation


Development of Shoulder Bursitis

Shoulder bursitis develops due to continuous friction or pressure on the bursa, leading to inflammation. Here’s how the condition typically develops:

  • Friction and Repetition: Repeated or high-intensity shoulder movement causes the bursa to swell.

  • Chemical Irritation: Friction releases chemicals that irritate the bursa, leading to inflammation.

  • Structural Imbalance: Muscle imbalances or poor posture can increase strain, worsening bursitis over time.

This irritation triggers pain and stiffness, often limiting shoulder function and strength.


Treatment Options for Shoulder Bursitis

A range of treatments can alleviate shoulder bursitis symptoms, from rest and home care to medical and alternative therapies.

1. Conservative Treatments

  • Rest and Activity Modification: Avoiding repetitive shoulder motions and resting the joint.

  • Ice and Heat: Applying ice to reduce inflammation or heat to relieve muscle stiffness.

  • Physical Therapy: Strengthening exercises to stabilize shoulder muscles and ease joint stress.


2. Medications

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Ibuprofen or naproxen for reducing pain and swelling.

  • Corticosteroid Injections: A steroid injection into the bursa to reduce severe inflammation and pain.


3. Acupuncture: A Natural Path to Relief

Acupuncture, an ancient Chinese therapy, is gaining recognition for its effectiveness in treating shoulder bursitis. This technique involves inserting fine needles into specific points to reduce pain, improve circulation, and restore function.

  • Pain Relief: Studies indicate that acupuncture releases endorphins, the body’s natural painkillers.

  • Enhanced Blood Flow: Needling promotes blood flow to the shoulder, supporting healing.

  • Reduced Inflammation: Acupuncture influences the body’s inflammatory response, decreasing bursa swelling.


This a a video of an acupuncture treatment with commentary by doctor and patient regarding the treatment and effects.

Scientific Evidence Supporting Acupuncture

Research supports acupuncture as an effective method for shoulder pain. A 2017 study in Pain Medicine found that acupuncture significantly reduced shoulder pain and improved mobility in patients with bursitis. Another review in Journal of Acupuncture and Meridian Studies highlights acupuncture's benefits, particularly for those experiencing chronic shoulder pain.


Acupuncture for Shoulder Bursitis: What to Expect

If you’re considering acupuncture, here’s a typical treatment process:

  1. Initial Consultation: The practitioner will discuss your symptoms and determine acupuncture points for treatment.

  2. Session Length: Sessions usually last between 30-60 minutes.

  3. Number of Sessions: Many patients find relief after 3 - 5 sessions, though this varies.

  4. Complementary Techniques: Acupuncturists may use additional therapies like cupping or moxibustion (heat therapy) to enhance results.


Other Alternative Treatments for Shoulder Bursitis

Beyond acupuncture, other alternative therapies may relieve shoulder bursitis symptoms:

  • Massage Therapy: Massaging shoulder muscles relieves tension and reduces strain on the bursa.

  • Chiropractic Adjustments: Chiropractors can improve shoulder alignment, reducing joint stress.

  • Yoga and Stretching: Gentle stretching improves flexibility and strengthens muscles supporting the shoulder.



Female javelin thrower
Now you've got your shoulder fixed you can go back to javelin throwing!

Preventing Shoulder Bursitis Recurrence

To avoid recurrent bursitis, it’s essential to adopt shoulder-friendly habits. Here are a few tips:

  • Practice Good Posture: Maintaining proper posture prevents undue stress on shoulder joints.

  • Strengthen Supporting Muscles: Exercises targeting the shoulder and back muscles provide joint stability.

  • Modify Repetitive Activities: If your work or hobbies involve repeated shoulder use, take breaks or adjust techniques.


Summary

Shoulder bursitis can be a challenging condition, but with the right approach, you can find relief and prevent future flare-ups. Acupuncture is a promising alternative treatment that offers pain relief and supports shoulder health. Combined with traditional treatments or other therapies, acupuncture can be an effective part of a comprehensive shoulder bursitis treatment plan.


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